• A Fassoulaki, C Sarantopoulos, and M Zotou.
• Department of Anesthesia, St Savas Hospital, Athens, Greece.
• Acta Anaesthesiol Belg. 1997 Jan 1; 48 (4): 233-8.

AbstractSystemic opioids enhance the spread of spinal analgesia. This study was designed to determine whether i.v. tenoxicam, a nonsteroidal anti-inflammatory drug (NSAID), affects the spread of sensory block produced by lidocaine. Sixty patients undergoing transurethral procedures were randomly assigned in a double blind design to receive i.v. either 3 ml normal saline (N/S group, n = 20), or 150 micrograms fentanyl (F group, n = 20), or 40 mg tenoxicam (T group, n = 20), 20 minutes after spinal anesthesia. The level of sensory loss was tested with pinprick sensation 20 minutes after subarachnoid block, but before i.v. treatment, and 5, 10, and 15 minutes after i.v. treatment. Five minutes after the i.v. treatment the change in the level of sensory block was -0.8 +/- 3.1 cm in the N/S group, 4.0 +/- 3.5 cm in the F group and 0.0 +/- 3.9 cm in the T group. The changes in the height of sensory block among the three groups differed 5 minutes and 10 minutes (F = 10.627, df = 2.57, P < 0.001 and F = 4.219, df = 2.57, P < 0.05 respectively), but not 15 minutes after i.v. treatment. Individual comparisons showed a difference between the N/S and F groups (P < 0.01), and between the F and T groups (P < 0.01) 5 minutes after treatment, and between the N/S and F groups (P < 0.05) 10 minutes after treatment. The overall change in the level of sensory block 15 minutes after i.v. treatment was -4.6 +/- 6.3 cm in the N/S group, 2.4 +/- 6.0 cm in the F group, and -1.6 +/- 5.8 cm in the T group. The F group differed from the N/S group (P < 0.01). Intravenous administration of tenoxicam does not enhance the level of spinal analgesia produced by lidocaine.

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